Unlock hundreds more features
Save your Form to the Dashboard
View and Export Results
Use AI to Create Forms and Analyse Results

Forgot Password?
Get Started
OR
Sign UpLogin With Facebook
Sign UpLogin With Google

Motor Vehicle Accident Report Form Template

Efficiently Document Vehicle Accidents with Our User-Friendly Template

After a motor vehicle accident, the chaos can be overwhelming, making accurate reporting essential. This template supports drivers and insurance agents in documenting all necessary details clearly and effectively, ensuring comprehensive reporting. Capture accident specifics, streamline insurance claims, and create an official record, all while benefiting from WCAG-aligned labels for accessibility. Explore the live template for your needs.

Use this Template (FREE) Live Preview
Your full name
Email address
Phone number
Your relationship to the incident
Driver involved
Passenger
Pedestrian
Cyclist
Vehicle owner (not present)
Witness
Prefer not to say
Other
Please Specify:
Date of accident
Time of accident (include AM/PM or 24-hour time)
Number of vehicles involved
1
2
3
4+
Unknown
Was this a hit-and-run?
Yes
No
Unknown
Brief description of what happened
Was anyone injured?
Yes
No
Unknown
Accident location (street or intersection, city, state/province, country)
Traffic control present at location
Please Specify:
Weather conditions at the time
Please Specify:
Road surface condition
Please Specify:
Are you reporting for a vehicle you were driving?
Yes
No
Not applicable
Driver full name
Seat belt used by driver
Yes
No
Unknown
Not applicable
Vehicle make and model
Vehicle year
License plate number
Insurance company
Insurance policy number
Airbag deployed
Yes
No
Unknown
Not applicable
Other driver full name
Other driver insurance company
Other driver insurance policy number
Other vehicle make/model/year
Other vehicle license plate number
Additional parties or vehicles involved (names, contact, roles)
Was another vehicle or property involved?
Yes
No
Unknown
Did anyone receive medical attention at the scene?
Yes
No
Unknown
Number of people injured
0
1
2
3
4+
Unknown
Nature of injuries (select all that apply)
Please Specify:
Names of injured persons and brief details
Emergency services called
Police
Ambulance/EMS
Fire
Tow truck
None
Unknown
Other
Please Specify:
Areas of damage to your vehicle
Please Specify:
Is your vehicle drivable?
Yes
No
Unsure
Was the vehicle towed?
Yes
No
Unknown
Property damage other than vehicles (describe)
Photo or video links (URLs)
Estimated damage severity
None
Minor
Moderate
Severe
Total loss
Unknown
Were police notified?
Yes
No
Unknown
Police report number (if known)
Citations or tickets issued
None
To me/my driver
To other driver
To multiple drivers
Unknown
Detailed incident narrative
Do you consent to be contacted about this report?
Yes
No
Signature (type your full name)
Signature date
I certify the information provided is true and accurate to the best of my knowledge
Yes
No
{"name":"Your full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Your full name, Email address, Phone number","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration depicting a motor vehicle accident report form for FormCreatorAI article

When to use this form

Use this form right after a collision, whether it is a minor fender bender, a hit-and-run, or a crash with injuries. It helps drivers, passengers, fleet managers, and safety teams capture facts while they are fresh, so insurance, HR, and legal can act fast. Common scenarios include a rear-end at a stoplight, a sideswipe in a parking lot, a weather skid, or damage to company vehicles. If you manage multiple incidents, connect submissions with your Incident report tracking form to assign follow-ups and deadlines. For workplace events, pair it with the Employee incident report form to keep HR and safety aligned. When everything is resolved, document outcomes and preventive steps in the Case closure form.

Must Ask Motor Vehicle Accident Report Questions

  1. What was the exact date, time, and location of the crash?

    This pins down jurisdiction, camera footage windows, and weather or road conditions at that moment. Precise details reduce disputes and speed insurance and internal reviews.

  2. Who was involved and how can we contact them (drivers, passengers, witnesses)?

    Full names, phone or email, license numbers, plates, and insurers let you coordinate statements and notices. Complete records prevent delays when verifying coverage or scheduling repairs.

  3. What were the vehicles doing before and during impact?

    A clear sequence (speed, direction, lane changes, signals) supports root-cause analysis and fair fault assessment. It also guides corrective action and driver coaching.

  4. What injuries and property damage occurred, and what immediate actions were taken?

    Documenting injuries, first aid, tow requests, spill containment, and temporary controls helps with compliance and duty of care. It also informs next steps, from medical follow-up to site remediation.

  5. Which authorities responded, and what evidence can you provide?

    Listing the agency, officer name, and any report number allows cross-reference with official records; attach photos, diagrams, and dashcam clips to strengthen the file. If force was used by responding officers, record that separately in the Police use of force report form.

More Forms

Copy/Edit Form Send to Recipients Make a Form w/AI Form Builder Must Ask Questions
  • 100% Free - No Catches
  • Collect Responses Today
  • Tailor to your Look & Feel